Changes in frontal cortex hemodynamic activity in a patient with schizophrenia undergoing electroconvulsive therapy – case analysis using functional near-infrared spectroscopy (fNIRS)

Abstract

Introduction: In recent years, one of the most interesting areas of research is the change in hemodynamic response of the prefrontal cortex as a predictor of response to electroconvulsive treatments (ECT). Near-infrared spectroscopy (fNIRS) is non -invasive functional neuroimaging technique that allows the assessment of neuronal activity in frontotemporal regions. The goal of our study was to verify feasibility of fNIRS method to monitor potential changes in frontal cortex hemodynamic activity as a response to ECT treatment. Material and method: The 30 years old, patient with schizophrenia was admitted to the Department of Psychiatry, Psychotherapy and Early Intervention in Lublin for psychiatric treatment. Due to the incomplete therapeutic effect, after using clozapine and electroconvulsive therapy was performed. To monitor the activity of the brain functional fNIRS technique was used. The hemodynamic response of the frontal cortex during performance was assessed: verbal and non-verbal fluency tasks. The Positive and Negative Symptoms Scale was used twice before and after ECT. Results: As a result of pharmacotherapy and electroconvulsive treatment, clinical improvement was achieved, but full remission was not achieved. Evaluation of HbO and Hb fluctuations from one channel showed that the hemodynamic activity of the frontal cortex was opposite to the standard at the time of task initiation. After a series of treatments, the pattern of activity reversed in a more normative direction for figural fluency. Discussion: It appears that the data provided indicate that fNIRS neuroimaging may be a useful tool in monitoring changes in cortical activity patterns in response to therapeutic stimulation such as ECT. Keywords: ECT, fNIRS, schizophrenia